Peripheral Neuropathy – Cancer.Net

adapted from: http://www.cancer.net/navigating-cancer-care/side-effects/peripheral-neuropathy

Preventing neuropathy related to chemotherapy

Currently, there is no good evidence that any medications, vitamins, or supplements can help you avoid neuropathy. Research on several antidepressants and other medications is ongoing but has not shown a consistent and/or strong benefit in preventing peripheral neuropathy from chemotherapy. In addition, ASCO does not recommend the following vitamins or supplements to prevent neuropathy from chemotherapy for the same reasons:

Acetyl-L-carnitine
Calcium and magnesium
Glutathione
Vitamin E
Managing neuropathy

Relieving side effects, also called symptom management, palliative care, or supportive care, is an important part of cancer care and treatment. Talk with your health care team about any symptoms you experience, including new symptoms or a change in symptoms.

How peripheral neuropathy is treated depends on the cause and the related symptoms. Many people recover fully from the disorder over time, in a few months or a few years. Sometimes, the condition may be more difficult to treat and may require long-term management. Your doctor will work to diagnose and eliminate the cause of your neuropathy and manage symptoms. There are a number of methods available that may provide some relief:

Medication. Although medication cannot reverse the neuropathy, it may relieve the pain. However, it does not relieve the numbness. The most common medications to treat neuropathic pain are anticonvulsants and antidepressants. For neuropathy related to chemotherapy, the American Society of Clinical Oncology (ASCO) recommends the antidepressant duloxetine (Cymbalta), as other medications have not been shown to have as much of a benefit. Over-the-counter pain medications may be recommended for mild pain. Prescription nonsteroidal anti-inflammatory drugs or very strong painkillers called analgesics may be prescribed for severe pain. Topical treatments, such as lidocaine patches and creams, may also help control pain. However, the medications used to manage neuropathy are related to your specific situation and the cause of your neuropathy.

Better nutrition. Eating a diet rich in B vitamins (including B1 and B12), folic acid, and antioxidants may help manage neuropathy. You should also eat a balanced diet and avoid drinking too much alcohol.

Physical and/or occupational therapy. Physical and/or occupational therapy can keep muscles strong and improve coordination and balance. Therapists can often recommend assistive devices that may allow you to more easily complete your usual daily activities. Regular exercise may also help reduce pain.

Complementary medicine. Massage, acupuncture, and relaxation techniques may help decrease pain and reduce mental stress. Additional tips include placing stress mats for feet in your home and work environment and wearing shoes with a rocker bottom sole.

Safety at home

Depending on your symptoms, these tips may help you avoid injury in your home if you have sensory or motor difficulties:

Keep all rooms, hallways, and stairways well lit.
Install handrails on both sides of stairways.
Remove small area rugs and any other clutter that could cause you to trip or slip.
Install grab bars in the shower or handgrips in the tub, and lay down skid-free mats.
Use a thermometer to check that any water you bathe in or use is below 110 degrees Fahrenheit, or set your water heater accordingly.
Clean up any spilled water or liquids immediately.
Use non-breakable dishes.
Use potholders while cooking and rubber gloves when washing dishes.
If you drive, make sure you can fully feel the gas and brake pedals and the steering wheel and that you can quickly move your foot from the gas pedal to the brake pedal.
If prescribed, use a cane or walker when moving from one room to the other.